Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly

• Type of Material: Article
• Authors: Christine F. Ward, Emory University; Gary S. Figiel, Emory University; William McDonald, Emory University
• Language: English
• Date: 2020-08-01
• Publisher: Elsevier: 12 months
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jagp.2020.05.013
• Title of Journal or Parent Work: American Journal of Geriatric Psychiatry
• ISSN: 1064-7481
• Volume: 28
• Issue: 8
• Start Page: 808
• End Page: 811
• Keywords: Psychiatry; altered mental status; Life Sciences & Biomedicine; COVID-19; Gerontology; Geriatrics & Gerontology; Science & Technology
• Research Categories: Gerontology; Psychology, Clinical

Abstract

The coronavirus disease of 2019 or COVID-19 was first identified in Hubei Province in China in November of 2019 and quickly spread to become a global pandemic. The virus, SARS-Coronavirus-2, is particularly virulent in the elderly who can develop symptoms and become mortally ill within days of contracting the virus. The virus is easily transmitted by droplets (e.g., sneezing and coughing) and communal living settings such as personal care homes can be vulnerable to the spread of the virus. Identifying patients early in the disease process is important to providing appropriate medical interventions. To date, most of the medical literature, including Center for Disease Control guidelines, has relied on three necessary symptoms in making the diagnosis of COVID-19: fever, cough, and shortness of breath. We present four cases of elderly patients who developed altered mental status as their presenting symptom without associated fever or respiratory symptoms.